How to Treat Adult Acne

Adult acne continues to increase and become more common. Other episodes of DermTV have discussed what causes adult acne and how to prevent it. Today, I’ll tell you how to TREAT it because it's a little different from how you treat teen acne.

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According to a study presented at the American Academy of Dermatology meeting in 2012, more and more female adults are getting acne. The statistics are alarming: 45% of women in their 20’s, 26% in their 30’s, and 12% in their 40’s. And in fact, from my experience, I would have thought the percent in the 40’s is even higher, where these women also have the unfortunate double whammy of pimples meeting wrinkles!

Lets start with washing…you still need to wash twice a day, even though you’re not as oily as you used to be. Most acne cleansers are designed for teenage oil and water, where the skin is very oily and not dry. However, as you get older, your facial skin tends to get drier from accumulated sun damage and simply from the aging process. So adult acne with less oily and more dry skin requires milder cleansers and alcohol free toners.

Cleansing needs to be gentle, so don’t use a wash cloth. Yes, in theory the cloth can help with some physical exfoliation, but for better exfoliation, use a chemical exfoliant like glycolic or even salicylic, so use your hands when washing your face. And also make sure the water is warm, not hot, to avoid over drying already dry skin.

Next, since our hair also dries out as we age, conditioner becomes more important after shampooing. But make sure to thoroughly rinse your forehead afterwards so your conditioner doesn’t coat your skin and cause breakouts.

For spot treatment of blemishes, not only are you dealing with dryer skin, but since adult acne often affects the jaw line and top of your neck… more sensitive skin areas than mid and upper face as in teen acne… for spot treatments try 1% salicylic products instead of 2%, and 2 ½% benzoyl peroxides instead of more drying 5% or 10%. While prescription topical antibiotics are great, make sure yours isn’t a combination antibiotic with a retinoid like tretinoin - more commonly known by the brand name Retin-A. Retinoids can very easily irritate these areas.

But my favorite and the best treatment for controlling adult acne is the off label use of low dose isotretinoin, formerly available as Accutane, and today readily available as a generic or under brand names like Ascorbica. Recent studies have shown excellent control with daily doses as low as 5mg per day. But you’ll need to see your dermatologist for this one. The FDA controls access to it with greater security than the Federal Reserve guards its gold inventory.